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16层螺旋多排探测器计算机断层扫描虚拟膀胱镜检查在评估一名疑似膀胱肿瘤且有膀胱癌手术史患者中的应用

Sixteen-slice multidetector computed tomographic virtual cystoscopy in the evaluation of a patient with suspected bladder tumor and history of bladder carcinoma operation.

作者信息

Basak Muzaffer, Ozkurt Huseyin, Tanriverdi Orhan, Cay Esra, Aydin Mustafa, Miroglu Cengiz

机构信息

Department of Radiology, Sisli Etfal Education and Research Hospital, Istanbul, Turkey.

出版信息

J Comput Assist Tomogr. 2009 Nov-Dec;33(6):867-71. doi: 10.1097/RCT.0b013e318199d6da.

Abstract

PURPOSE

The purpose of this study was to evaluate the use of virtual cystoscopy performed with multidetector computed tomography (CT) in patients with suspected bladder tumors and histories of bladder carcinoma operation.

MATERIAL AND METHODS

Thirty-six patients (29 men and 7 women) with a mean age of 66 years (range, 24-88 years) with suspected bladder tumors and histories of bladder carcinoma operation were included in this prospective study. Virtual cystoscopy was performed by 16-slice multidetector CT scanner. The bladder was filled with diluted contrast material solution through a Foley catheter. Then, all patients underwent conventional cystoscopy examination.

RESULTS

Two reviewers found 18 lesions detected by virtual cystoscopy by consensus, whereas 19 lesions were depicted by conventional cystoscopy. At virtual and conventional cystoscopies, the conditions of 3 patients, 2 with chronic inflammations and 1 with foreign body reaction, were wrongly diagnosed as tumors. At conventional cystoscopy, one patient's result was wrongly interpreted as normal. In pathologic evaluation, all tumors were diagnosed as transitional cell carcinoma.

CONCLUSIONS

Bladder tumor can be noninvasively diagnosed using virtual cystoscopy. Use of virtual cystoscopy should be considered inpatients who present with hematuria or have histories of bladder carcinoma operation and are for follow-up because of its lesser complication risk and its being a less invasive, easily applied procedure without need of anesthesia. In the future, owing to the development of the CT technology and image processing technique, virtual cystoscopy may have a part in the detection of bladder cancer.

摘要

目的

本研究旨在评估对疑似膀胱肿瘤且有膀胱癌手术史的患者使用多排螺旋计算机断层扫描(CT)进行虚拟膀胱镜检查的应用情况。

材料与方法

本前瞻性研究纳入了36例患者(29例男性和7例女性),平均年龄66岁(范围24 - 88岁),这些患者疑似患有膀胱肿瘤且有膀胱癌手术史。使用16层多排螺旋CT扫描仪进行虚拟膀胱镜检查。通过Foley导管向膀胱内注入稀释的造影剂溶液。然后,所有患者均接受了传统膀胱镜检查。

结果

两名阅片者经共识确定虚拟膀胱镜检查发现18个病变,而传统膀胱镜检查发现19个病变。在虚拟膀胱镜检查和传统膀胱镜检查中,3例患者的情况被误诊为肿瘤,其中2例为慢性炎症,1例为异物反应。在传统膀胱镜检查中,1例患者的结果被错误解读为正常。在病理评估中,所有肿瘤均被诊断为移行细胞癌。

结论

使用虚拟膀胱镜检查可对膀胱肿瘤进行无创诊断。对于出现血尿或有膀胱癌手术史且因并发症风险较低、侵入性较小且无需麻醉即可轻松实施而需要进行随访的患者,应考虑使用虚拟膀胱镜检查。未来,由于CT技术和图像处理技术的发展,虚拟膀胱镜检查可能在膀胱癌的检测中发挥作用。

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